erythroderma

erythroderma

Erythroderma is a general term referring to many skin lesions (including erythroderma, a variant of T-cell lymphoma); characterized by generalized reddening of the skin with pronounced large-lamellar peeling. Frequency – 1% of all hospitalizations for skin diseases, more often men (2: 1) over 40 years of age get sick. Etiology and risk factors

    • Toxicodermia
    • Lymphomas
    • contact dermatitis
    • Atonic dermatitis
    • colon cancer
    • fungal diseases
    • HIV infection
    • Ichthyosoform dermatoses
    • Leukemia
    • Lichen planus
    • Lungs’ cancer
    • myeloma
    • Pemphigus foliaceus
    • Photodermatitis
    • Ringworm red hair
    • Psoriasis
    • pyoderma
    • Reiter’s syndrome
    • Scabies
    • Seborrheic dermatitis
    • Cesare syndrome
    • Lyle’s disease
    • Stasis dermatitis
    • SLE
    • Toxic epidermal necrolysis.

Genetic aspects. To date, 2 inherited forms have been identified (173200, ED, pityriasis rubra pilaris; 270300, p, congenital exfoliative keratosis).

Clinical picture

    • In the early stages
    • With an acute onset or development of the disease against the background of exudative dermatitis – thinning of the epidermis, erythema, exudation with subsequent formation of crusts
    • Exacerbation of a concomitant disease, then fine-lamellar generalized peeling with non-cordial erythema and lichenification of the skin
    • In the absence of a concomitant disease – a predominant lesion of the skin of the trunk, perineum and head, then – generalization of lesions.
    • In the next
    • Severe itching, feeling of thickening of the skin, dry mucous membranes, nail dystrophy, baldness
    • Malaise, tachycardia, chills, fever
    • Lymphadenopathy
    • Liver enlargement, spleen enlargement (if there is associated lymphoma or leukemia)
    • Gynecomastia
    • Steatorrhea.

Research methods

    • Blood test: moderate leukocytosis, eosinophilia, micro- and macrocytic anemia, increased ESR, hypoalbuminemia, electrolyte disturbances
    • Biopsy of skin, lymph nodes, and bone marrow to identify underlying disease. differential diagnosis. Acute dermatoses, for example, contact dermatitis and toxicosis.

Treatment:

Tactics of conducting

    • Cancellation of products that cause exacerbation of the skin process
    • Treatment of comorbidities, antibiotics or antifungals for superinfection
    • With unclear etiology – symptomatic therapy; probably an unexpected cure. Drug therapy
    • Glucocorticoids, for example, prednisolone 40 mg / day orally, if there is no effect, the dose is increased by 20 mg / day each

dye 3-4 days (no more than 100 mg / day). Subsequently, the dose is reduced to maintenance

    • Glucocorticoids locally – with localized lesions
    • Glucocorticoids should be used with caution in exfoliative dermatitis caused by atonic or seborrheic dermatitis
    • Contraindications – exfoliative dermatitis in psoriasis.
    • Antihistamines – to relieve itching.
    • With erythroderma due to psoriasis – methotrexate, etretinate, phototherapy and other specific treatments.
    • With erythroderma caused by mycosis fungoides, photochemotherapy.
    • With erythroderma due to tinea pedis, isotretinoin.

Complications

    • Bacterial, fungal superinfection
    • Dehydration, electrolyte disturbances
    • Heart failure. The prognosis for patients with idiopathic exfoliative dermatitis is unfavorable.

Synonym. Exfoliative dermatitis ICD. L26 Exfoliative dermatitis